Centuries of child labor left lasting spinal damage in Dutch children, study finds
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Children in the postmedieval Dutch workforce worked so hard that their spines became worn and deformed, with some children affected before they even had a chance to lose their baby teeth, a new study published in the International Journal of Paleopathology finds.
Researchers examined the backs of Dutch children ages 4–25 who lived between the 1600s and 1800s. They found worn-down spinal joints, bony lips growing on the edges of vertebrae and dents in the discs cushioning the spine—signs modern doctors typically associate with old age and years of grueling physical work, not elementary school-age children.
“It was honestly heartbreaking,” lead study author Alex Tutwiler, a Ph.D. candidate at Leiden University, said. “As scientists we develop hypotheses and test them, but it’s hard to factor in the emotional impact that work like this can have until you’re in the process of actually analyzing the skeletal remains of these children.”
Built on the backs of children
Child labor has a long history in the postmedieval Netherlands. From the early 1600s, children increasingly became part of the workforce. By the 1800s, census data suggested children made up around 5% of the workforce, or around 27,200 children. According to the study, children began working as young as 4, with workdays lasting 12, 15 and sometimes even 17 hours.
Historic accounts describe the hours of work, wages paid and duties given to these children but remain eerily silent on the effects these conditions had on children’s bodies. One poem written in 1853 by a Dutch textile worker describes these children as little people with pale faces and “very weak little hands.”
Tutwiler and her co-author, Rachel Schats of Leiden University, wanted to know what stories the bones had to tell. So they turned to the remains of 143 children documented as having worked on rural dairy farms in Middenbeemster and urban industrial factories in Arnhem. They then compared their findings with those from children who had lived affluent, nonworking lives in Delft.
Soon, the grim reality became clear. Children from Middenbeemster were hit hardest. According to the study, records show that children as young as 9 were expected to work, hauling milk basins and lugging cheese molds. This heavy lifting and repetitive movement wore down the joints in their upper backs.
Tutwiler compared the worn joints to wearing too-small shoes: Your feet get cuts and blisters and eventually start changing shape, and, with time, your shoes change shape as well. “This is, on a very basic level, what is happening in your joints,” she said.
The children also suffered from Schmorl’s nodes. Tutwiler compared them to a squishy net stress ball. When your spine has too much pressure, the soft discs between your vertebrae begin to pop: “Like the gooey stress ball popping through the net.”
Surprisingly, Arnhem’s factory children were more similar to the wealthy children of Delft. The study suggests that while spinning, sewing and weaving for 12 hours were exhausting, they did not exert nearly as much stress on the spine, although lower-back problems were still present.
The few instances of spinal damage among the children of Delft may have resulted from play or horseback riding, the study speculated. Conversely, too little physical activity caused damage, as these children were expected to study, sit and read for hours on end.
Why it matters now
After centuries of suffering, the Netherlands eventually banned child labor, Tutwiler said, but the practice remains a gruesome reality worldwide. The United Nations Children’s Fund estimated that a staggering 137.6 million children were forced into labor worldwide in 2024. But the long-term effects on their bodies are only partially understood, in part because these children rarely seek medical care.
Tutwiler hopes to use CT scans next to see how children’s arms and legs are affected.
Old bones offer a window into the past and present that modern medicine sometimes can’t. “Reading the historical accounts of child labor in the Netherlands during this period is one thing, but actually seeing the effects of child labor on growing bones is entirely different.”
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More information
Alex Tutwiler et al, Built on the backs of children: A comparative analysis of spinal joint disease in non-adults from three post-medieval (1650–1850 CE) Dutch communities with documented histories of child labour, International Journal of Paleopathology (2026). DOI: 10.1016/j.ijpp.2026.07.002
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Centuries of child labor left lasting spinal damage in Dutch children, study finds (2026, August 29)
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